Contributions to OREF have long-term benefits

Research funded in part by the Orthopaedic Research and Education Foundation (OREF) and conducted by Victor M. Goldberg, MD, led to transplant tissues that were less likely to be rejected by the patient’s body, as well as new treatments for arthritis. Dr. Goldberg hopes that his years of promoting orthopaedic research through leadership, advocacy, and direct contributions to OREF will spur equally important research for the future.

“I’ve been in orthopaedics for about 40 years and it’s been an incredible life,” Dr. Goldberg said. “I’ve done what I love to do, and I understand the importance of the future.”

Currently a member of the AAOS Council on Research, Quality Assessment, and Technology, Dr. Goldberg served as an OREF trustee for 9 years, including 2 years as chair. He and his wife, Harriet, are longtime OREF Order of Merit donors and members of the Shands Circle. In 2003, they made a $1 million commitment to OREF, which was completed through cash and stock gifts in 2007.

Dr. and Mrs. Goldberg chose to endow an OREF Research Grant, which awards $50,000 each year for 2 years to a recipient selected through OREF’s peer review process. “I understand that discoveries won’t happen tomorrow,” Dr. Goldberg said. “Just like any other investment, you have to have patience.”

A career in research
Dr. Goldberg first became interested in the topics of rheumatoid arthritis and transplant immunology during his postresidency training. He was pursuing his goal of becoming a clinician scientist at the Clinical Research Center (CRC) at Northwick Park, England’s equivalent to the U.S. National Institutes of Health.

At the CRC, Dr. Goldberg worked with the late Eugene M. Lance, MD, PhD, an immunologist and orthopaedic surgeon. The CRC team was investigating the processes that led to rheumatoid arthritis and other inflammatory arthritic conditions, as well as the transplantation process and transplant immunology. Many of the patients in Dr. Goldberg’s unit had arthritic conditions.

“I became interested in studying arthritis,” Dr. Goldberg said. “During my time studying transplant immunology, I developed techniques to better understand the causes and etiology of rheumatoid arthritis.”

When he returned to the United States, Dr. Goldberg became the director of a comprehensive arthritis program at Case Western Reserve University, consulting with rheumatologists to manage patients’ rheumatoid arthritis.

“We took a holistic approach—nonsurgical, surgical, and rehabilitative,” Dr. Goldberg said. “I also wanted to continue my research, and the department provided a laboratory and start-up funds.”

Researching arthritis
Dr. Goldberg began building parallel clinical and basic science research programs. The clinical program investigated the underlying causes of rheumatoid arthritis. The laboratory program created an animal model of rheumatoid arthritis, which he used as the basis for his OREF grant applications.

In the 1970s, Dr. Goldberg received three OREF Research Grants to support his research. He found that specific antigenic markers stimulate the production of antibodies related to autoimmune disease.

“We found that rheumatoid arthritis was probably genetically determined to some extent, which created a problem for patients. The patients’ own immune systems turned against them, creating an inflammatory response that ultimately destroyed their joints,” Dr. Goldberg explained.

These results indicated that rheumatoid arthritis is an autoimmune disease. From this work came an understanding of how the environment leads to the destruction of bone, cartilage, and ligaments. Further investigations sought ways to stop the destruction.

“Some of that work clearly enabled other people to develop specific therapeutic drugs,” Dr. Goldberg said. “Many current drug treatments are directed toward specific chemokines, or mediators of inflammation.”

Researching transplant immunology
In addition to his investigations of the causes of arthritis, Dr. Goldberg used his OREF grants to explore and amass preliminary data on transplant immunology, particularly on how musculoskeletal tissues, such as bone, cartilage, and ligaments, are incorporated into the body. His research resulted in modifications that helped reduce rejection rates. Nearly 30 years later, the use of bone to reconstruct bony defects caused by trauma, arthritis, or a tumor has vastly improved and become standard procedure for most orthopaedists.

“If I hadn’t had the seed money from OREF to continue to run my laboratory—for the technical help as well as the equipment and other necessities—I don’t believe I could have continued as a clinician scientist,” admitted Dr. Goldberg.

By endowing an OREF Research Grant, Dr. Goldberg hopes to do the same for the next generation of clinician scientists. “I couldn’t be happier with the quality of the young people coming into orthopaedics now. If my generation doesn’t provide for them to continue research, in 20 to 40 years orthopaedics will not have reached its full potential of devising unique, effective ways to manage orthopaedic problems. I feel very strongly that supporting research is a responsibility for all of us and that my contribution is doing something for the future.”

Receiving accolades and passing them along
In March 2008, in conjunction with the AAOS Annual Meeting, Dr. Goldberg was named recipient of the Orthopaedic Research Society-OREF Distinguished Investigator Award. Recently, the Arthritis Foundation asked Dr. Goldberg to participate in a gala honoring Jorge O. Galante, MD, DMSc, a fellow pioneer of arthritis research, who received the 2008 Arthritis Foundation Freedom of Movement Award.

Amy Kile, OREF publications manager, can be reached at kile@oref.org